How appropriate is this game for a 14 year old?

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I know it is rated M, but the first one wasn't that bad and my cousin loved it, he wants this one, but he didn't get it for Christmas, his birthday is January 23rd though, so is this game really that bad, could a 14 year old handle it, I wanna get it for him, but I don't want my aunt to get mad.

There is lots of violence (which for some reason doesn't typically bother parents), lost of cussing including the f bomb (which does bother them) and strong sexual suggestion. There is also religious overtones.